• Smokers tolerated higher doses of erlotinib.
• Erlotinib is used as a second-line therapy.
• Side effects included rash and diarrhea.

CORONADO, Calif. — Although erlotinib is an approved second-line therapy for lung cancer, its management is complicated by side effects that get worse as the dose increases.

“Increased doses may lead to better outcomes, so we are trying to determine how high we can go with this agent without having to stop,” said Lynsay Waller, M.D., a fellow at Wake Forest University, who presented her data at the AACR-IASLC Joint Conference on Molecular Origins of Lung Cancer, held here Jan. 11-14, 2010.

Waller and colleagues evaluated 25 patients and put them on a chemotherapy regimen that began with docetaxel, cisplatin and pegfilgrastim growth factor support. The researchers then started administering erlotinib at 150 mg daily for non-smokers and 300 mg daily for smokers. These doses were increased every two weeks until development of grade 2 toxicity, when the doses stabilized. If grade 3 toxicity emerged, the doses were cut back by 75 mg a day.

Doses reached as high as 525 mg for smokers and 225 mg for non-smokers, but by the end of the study most smokers had a maximum tolerated dose of 300 mg compared with 225 mg for non-smokers.

The most common reasons for discontinuation of therapy was grade 2 rash, grade 2 or grade 3 diarrhea or grade 3 dehydration.

The mission of the American Association for Cancer Research is to prevent and cure cancer. Founded in 1907, the AACR is the world’s oldest and largest professional organization dedicated to advancing cancer research. The membership includes 30,000 basic, translational and clinical researchers; health care professionals; and cancer survivors and advocates in the United States and nearly 90 other countries. The AACR marshals the full spectrum of expertise from the cancer community to accelerate progress in the prevention, diagnosis and treatment of cancer through high-quality scientific and educational programs. It funds innovative, meritorious research grants, research fellowship and career development awards. The AACR Annual Meeting attracts more than 16,000 participants who share the latest discoveries and developments in the field. Special conferences throughout the year present novel data across a wide variety of topics in cancer research, treatment and patient care. The AACR publishes six major peer-reviewed journals: Cancer Research; Clinical Cancer Research; Molecular Cancer Therapeutics; Molecular Cancer Research; Cancer Epidemiology, Biomarkers & Prevention; and Cancer Prevention Research. The AACR also publishes CR, a magazine for cancer survivors and their families, patient advocates, physicians and scientists. CR provides a forum for sharing essential, evidence-based information and perspectives on progress in cancer research, survivorship and advocacy.